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Catheter Care Policy

Aim

Cavendish Homecare Professionals’ aim is to ensure that where a client requires an indwelling urinary catheter as part of their care and treatment, suitably trained care staff will be deployed to support them as required and provide high quality care that conforms to best practice.

Policy

  • Personal care and assistance will be provided for clients who have catheter care needs, including meeting personal hygiene needs and helping clients to empty urine bags as required.
  • Catheter care needs will be identified in the initial needs assessment and a plan of care agreed with the client and their relatives or carers. Domiciliary care managers will liaise with other agencies, such as the healthcare providers involved in the management of the catheter, to agree the plan. Healthcare providers involved, in addition to the GP and primary healthcare team, are likely to include specialist continence nurses and advisors, or urology consultants.
  • Only homecare staff who are trained and competent in catheter care will be deployed to provide assistance for a client with catheter care needs. Where necessary, the organisation will work with partner healthcare agencies to ensure that the proper training is completed and acceptable competency standards are achieved.
  • Care staff will work in partnership with the client to manage the catheter in such a way that preserves the client’s dignity, independence and privacy and reduces the chance of infection.
  • Necessary catheter maintenance and personal hygiene tasks should be undertaken by appropriately trained staff according to the client’s agreed Care Plan. To reduce the chance of infection it is important that the catheter and skin is kept clean and dry. Help may be provided to the client to achieve this, the point at which the catheter enters the body being carefully cleaned daily with soap and water.
  • Urine bags should be regularly emptied. They should not be allowed to fill more than three-quarters full to avoid traction on the bladder.
  • When emptying a urine bag, care staff should:
    • always wash hands with soap and water first and dry hands well
    • place a jug under the bag outlet tap and open to allow the urine to drain (avoid contact from the tap to the jug to reduce the risk of infection)
    • when emptying, close the bag outlet tap and wipe with a tissue
    • care must be taken to avoid contamination of the tap
    • ensure the leg bag is placed back in a comfortable position for the client
    • dispose of contents of jug into the toilet
    • rinse out jug with warm soapy water and allow to dry
    • wash and dry hands again.
  • Where necessary, a leg bag may need adjusting to ensure it is comfortable. The urine will need to drain downwards into the bag, which should be secured to the leg so that it does not pull.
  • To prevent infection, the connection between the catheter and the urinary drainage system should not be broken except for changing the bag in line with the manufacturer’s recommendations. Care staff may be asked to assist the client with attaching a night bag and disposing of it in the morning. Scrupulous attention should be paid to cleanliness and hand washing when assisting a client, and appropriate personal protective equipment should be worn (i.e. disposable gloves).
  • Where required, the urine output should be measured and the volume entered on a chart or in the client’s records. Where regular monitoring is required, this should be entered into the Care Plan.
  • Where necessary, a urine sample should be taken using a clinically clean technique.
  • All relevant infection control procedures will be taken to try to avoid catheter associated urinary tract infections. Staff should use disposable gloves and wash their hands before and after any catheter care, including personal hygiene tasks and emptying bags.
  • Clients will be afforded all privacy and dignity when undergoing catheter maintenance care. Clients and carers should be given all possible information about catheter care and management and about the symptoms of urinary tract infections. Information should focus on the importance of catheter hygiene and the avoidance of catheter-related problems.
  • Where any complication with the catheter or urine output is noted or identified, including signs of infection, blockage, pain or discomfort, this should immediately be reported to the healthcare professional responsible for the client’s care, or to their GP or primary healthcare team.
  • The client’s clinical need for continuing urinary catheterisation should be reassessed regularly by their GP in collaboration with a specialist or continence team. The risk of urinary tract infection rises with the length of time a catheter remains in place.

Training

Care staff who will be expected to provide care for clients with catheters should have appropriate training. This will usually be arranged with the local community healthcare services. Records of training should be kept.

Management duties

Domiciliary care managers have a duty to:

  • ensure that the needs of clients are properly identified and the plan of care discussed and agreed with the relevant healthcare providers
  • ensure and monitor compliance with this policy, with linked policies and with national best practice in catheter care
  • ensure that care staff are capable of delivering the requirements of this policy and do so effectively
  • provide effective supervision and training for care staff performing delegated functions relating to catheter care
  • respond to and investigate any reported incidents or issues relating to catheter care
  • audit this policy and any infection control reports on a regular basis, investigating incidents and taking appropriate action.

Staff duties

Care staff have a duty to:

  • provide clients with the best possible care at all times, including supporting their personal hygiene needs as required in their plan of care
  • use disposable gloves where required and implement all necessary infection control precautions and procedures
  • always report any complications or concerns, including any signs of urine retention, blockage or signs of pain/infection or discomfort
  • always treat clients with the appropriate compassion, privacy, dignity and respect
  • participate in training activities relating to infection control and catheter care.

 

 

Date: January 2024

Version: 7 (Review)

Source:  ECM